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BACKGROUND Diagnosis-based case-mix measures are increasingly used for provider profiling, resource allocation, and capitation rate setting. Measures developed in one setting may not adequately capture the disease burden in other settings. OBJECTIVES To examine the feasibility of adapting two such measures, Adjusted Clinical Groups (ACGs) and Diagnostic(More)
CONTEXT Currently most automated methods to identify patient safety occurrences rely on administrative data codes; however, free-text searches of electronic medical records could represent an additional surveillance approach. OBJECTIVE To evaluate a natural language processing search-approach to identify postoperative surgical complications within a(More)
An empirically derived risk adjustment model is useful in distinguishing among facilities in their quality of care. We used Veterans Affairs (VA) administrative databases to develop and validate a risk adjustment model to predict decline in functional status, an important outcome measure in long-term care, among patients residing in VA long-term care(More)
BACKGROUND Previous studies have suggested that older women may be more likely than older men to receive potentially inappropriate prescriptions. A better understanding of sex differences in inappropriate prescribing can help inform the development of effective interventions. OBJECTIVE This study was conducted to assess sex differences in rates of(More)
OBJECTIVE The quality of outpatient medical care is increasingly recognized as having an important impact on mortality. We examined whether a clinically credible risk adjustment methodology can be developed for outpatient quality assessments. RESEARCH DESIGN This study used data from the 1998 National Survey of Ambulatory Care Patients, a prospective(More)
BACKGROUND Although difficulties in applying risk-adjustment measures to mental health populations are increasingly evident, a model designed specifically for patients with psychiatric disorders has never been developed. OBJECTIVE Our objective was to develop and validate a case-mix classification system, the "PsyCMS," for predicting concurrent and future(More)
PURPOSE The objective of this study was to compare gender differences in mental health disease burden and outpatient mental health utilization among veterans utilizing Veterans Health Administration (VHA) mental health services in fiscal year 1999 (FY99), after the first Gulf War and significant restructuring of VHA services. METHODS We used logistic(More)
OBJECTIVE To assess the performance of Diagnostic Cost Groups (DCGs) in explaining variation in concurrent utilization for a defined subgroup, patients with substance abuse (SA) disorders, within the Department of Veterans Affairs (VA). DATA SOURCES A 60 percent random sample of veterans who used health care services during Fiscal Year (FY) 1997 was(More)
BACKGROUND Many studies have identified patient characteristics associated with potentially inappropriate prescribing in the elderly (PIPE), however, little attention has been directed toward how health care system factors such as geriatric care may affect this patient safety issue. OBJECTIVE This study examines the association between geriatric care and(More)
BACKGROUND The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) use administrative data to detect potentially preventable in-hospital adverse events. However, few studies have determined how accurately the PSIs identify true safety events. OBJECTIVES We examined the criterion validity, specifically the positive predictive(More)